YOUR CART

Electronic Consent

Before you purchase any of our camp packages, please be sure to read and consent to the ﻿Acknowledgment of Risk and Release of Liability.You can do this by either printing the form from our Services & Forms page and bringing it with you to your first camp session, or by filling out the below information and electronically agreeing to the form. ﻿﻿﻿﻿

Name *

First

Last

* Indicates required field

Email *

Phone Number *

D.O.B (MM/DD/YYYY) *

01/02/1989

You are hereby acknowledging, and is volunteering to participate in a program provided by
(Peak Performance Fitness), which may include, but not limited to, resistance training, sports therapy
including massage service, nutritional plans and aerobic or cardiovascular exercises. In consideration of
Trainer’s agreement to instruct and train me, I do here now and forever release and discharge and
hereby hold harmless Peak Performance Fitness LLC and any respective agents, heirs, assigns,
contractors, and employees from any and all claims, demands, damages, rights of action or causes of
action, present or future, arising out of or connected with my participation in this or any
exercise/nutrition/wellness program including any injuries resulting there from. THIS WAIVER AND
RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES WHICH MAY OCCUR AS A RESULT OF
(1) EQUIPMENT BELONGING TO TRAINER OR TO MYSELF THAT MAY MALFUNCTION OR BREAK; (2) ANY
SLIP, FALL, DROPPING OF EQUIPMENT; (3) AND/OR NEGLIGENT INSTRUCTION OR SUPERVISION, as well
as abnormal changes in blood pressure, fainting, and a remote risk of heart attack, stroke, other serious
disability or death, and that I am voluntarily participating in these activities and using equipment and
machinery with full knowledge, understanding and appreciation of the dangers involved. I hereby agree
to expressly assume and accept any and all risks of injury, regardless of severity, or death.
I acknowledge that I have been advised that an examination by a physician should be obtained
prior to commencing any physical or nutritional program provided by Peak Performance Fitness. If I have
chosen not to obtain a physician’s consent prior to beginning any program provided by any Trainer
representing Peak Performance Fitness LLC, then I hereby agree that I am doing so solely at my own risk.
In any event, I acknowledge and agree that I assume the risks associated with any and all fitness related
activities and/or exercises in which I participate. I ACKNOWLEDGE THAT I HAVE THOROUGHLY READ
THIS FORM/DOCUMENT IN ITS ENTIRETY AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY.
BY SIGNING THIS DOCUMENT, I AM WAIVING ANY RIGHT AND/OR MY SUCCESSORS MIGHT HAVE TO
BRING A LEGAL ACTION OR ASSERT A CLAIM AGAINST PEAK PERFORMANCE FITNESS LLC FOR ANY
NEGLIGENCE OR THAT OF ANY EMPLOYEES, AGENTS, OR CONTRACTORS REPRESENTED.

By clicking "I Agree" below, I am agreeing with the Acknowledgment of Risk and Release of Liability and have read all terms and conditions. *